Free flaps have been widely used in lower leg reconstruction. However, in cases with extensive injury to the vessels as well as to the bone and soft tissues, and having only one intact major vessel in the lower leg(single vessel leg), careful selection of recipient vessels for the free flap transfer is mandatory for preventing further vascular compromise of the distal lower leg. The sural artery and its vena comitantes are frequently protected form externally harmful forces by the bulky surrounding gastrocnemius muscle and can be used as recipient vessles for free flaps without any detrimental influence on the vascularity of the distal lower leg. In our department, three latissimus dorsi muscle free flap were transferred with sural vessels as recipient vessels in the reconstruction of the single vessel legs. Except for one case of flap failure due to serious infection at the microvascular anastomoses site, all the other cases were successfully reconstructed without any necrosis of the gastrocnemius muscle or the distal leg. In addition, the sural vessels were easily accessed in any patient position and their caliber was similar to that of the vascular pedicles of the donor muscle flaps. In conclusion, the sural vessels can be another useful option in selecting recipient vessels for free flap transfer in the reconstruction of the single vessel leg.
Arteries ; Free Tissue Flaps* ; Humans ; Leg* ; Muscle, Skeletal ; Necrosis ; Superficial Back Muscles ; Tissue Donors

PURPOSE: A comparison analysis of the clinical characteristics and treatment results of congenital NLD obstruction. METHODS: The present study involved 216 pediatric patients (258 eyes) diagnosed with and treated for congenital NLD obstruction. Treatment was applied step by step starting with conservative massaging, lacrimal probing, and silicone tube intubation. RESULTS: The treatment results of congenital NLD obstruction in pediatric patients under 12 months of age showed an 87.3% success rate after an average of 4.3 months of treatment in the group using lacrimal sac massage and antibiotic eye drops (conservative treatment). The group treated by correct massaging techniques showed a 93.6% success rate after an average of 3.8 months of treatment. The success rate of lacrimal probing, applied to patients not showing improvement after massage therapy was 77.8%. Pediatric patients not showing improvement after lacrimal probing underwent silicone tube intubation. All patients showed improvement except in 1 case that had an early silicone tube dislocation. DISCUSSION: A step-by-step approach is effective in treating congenital NLD obstruction patients, and correct lacrimal massage techniques improve the success rate during conservative therapy. The period of conservative treatment and number of probing times did not have a statistically significant correlation with the success rate of lacrimal silicone tube intubation. Silicone tube intubation showed a high success rate in patients sustaining the silicone tube for a minimum of 2.1 months.
Dislocations ; Humans ; Intubation ; Massage ; Nasolacrimal Duct ; Ophthalmic Solutions ; Silicones

No abstract available.
Shock, Septic*

PURPOSE: To assess the relationship between the internal diameter of the nasolacrimal duct and the success rate of silicone tube intubation in incomplete nasolacrimal duct obstruction patients with epiphora. METHODS: Dacryocystography was performed 80 patients with symptoms of epiphora and the anteroposterior (AP) diameters and the lateral diameters of the nasolacrimal ducts were measured. These measurements were compared between the group of patients who demonstrated improvement after the operation, and the group without symptom improvement. RESULTS: The mean length of the nasolacrimal duct in the group with nasolacrimal stenosis was 11.7+/-0.1 mm, the mean lateral diameter was 1.0+/-0.2 mm, and the mean AP diameter was 1.1+/-0.1 mm. The AP diameter of the symptomatic nasolacrimal duct in the group with successful postoperative results was 1.1+/-0.1 mm, and 0.9+/-0.1 mm in the group with unsuccessful results. The group with successful postoperative results had an average of 18.1+/-7.0% stenosis in the side of the eye with nasolacrimal duct stenosis compared with the asymptomatic side, and the group with unsuccessful postoperative results had an average of 34%+/-3.6% stenosis. CONCLUSIONS: In cases with nasolacrimal duct stenosis, the success rate of silicone tube intubation was high when the AP diameter of the nasolacrimal duct was more than 1.1+/-0.1 mm and when the stenosis was less than 18.1+/-7.0% in the symptomatic side compared with the opposite side. These results are expected to help predict the success rates when preoperatively planning silicone tube intubation.
Constriction, Pathologic ; Eye ; Humans ; Intubation ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct ; Silicones

No abstract available.
Asphyxia* ; Evoked Potentials, Auditory* ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature* ; Parturition*

No abstract available.

Tuberculosis of the puboischium is an uncommon entity. The two constant features in tubereulosis of the pubis are limping and abscess formation. This disesse should be differentiated from other diseases such as osteitis pubis, suppurative osteomyelitis, postpartum synphysiolysis, and adolescent osteochondritis. Kirker advocated that wide excision of the lesion for the treatment of this disease is the best method. However, Nicholson(1953) reported that the lesion has a good prognosis snd responds well to simple curettage. Since the first reports by Thilesen(1855) and by Heinnies(1888), there were paucity of reports. Also in Korea, there have been no report about this disease. The five patients who were treated at the Ksng-Nsm St. Marys Hospitsl between 1982 and 1987 were reported. The results were as follows ; 1. Four patients were boys and one was a female. 2. All cases had clinically abscess, tenderness at the lesion, and limp. 3. Lesions in four cases responded well to simple curettage and18 months of chemotherapy. However, in one case fusion of the symphysis using a plate was performed because of tuberculosis-induced instability of the sacroiliac joint. 4. In a child, destroyed symphysis pubis was well restituted after treatment. Through the cases it is concluded that simple curettage and anti-tuberculous chemotherapy are good treatment modality for tuberculosis of the puboischium.
Abscess ; Adolescent ; Child ; Curettage ; Drug Therapy ; Female ; Humans ; Korea ; Methods ; Osteitis ; Osteochondritis ; Osteomyelitis ; Postpartum Period ; Prognosis ; Pubic Bone ; Sacroiliac Joint ; Tuberculosis

PURPOSE: The purpose of this study was to test the mediating effect of job embeddedness in the relationship between nursing practice environment on nursing job performance and organizational commitment. METHODS: For this study a descriptive design with survey method was utilized. Participants were 192 clinical nurses recruited from 2 hospitals in A, B city and J province in Korea. From June, 6 to 24, 2018, a questionnaire scale was used to collect the data. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation analysis, and liner regression analysis. RESULTS: There were significant positive relationships for nursing job performance and organizational commitment with nursing practice environment. In addition, job embeddedness had a full mediating role in the relationship between nursing practice environment and nursing job performance, and a partial mediation effect in nursing practice environment and organizational commitment. CONCLUSION: The purpose of this study was to identify the mediating effects of job embeddedness and to find ways to improve organizational commitment, which is a useful variable to predict performance outcomes, nurse job performance and job behavior of organizational members. Also, the study results can be used as basic data for nursing manpower management strategies.
Korea ; Negotiating ; Nursing ; Surveys and Questionnaires ; Work Performance

In Korea, all domestic made test systems for detecting antibodies in HIV-1 contain the antigens from human immunodeficiency type 1 (HIV-1) subtype B. However, because HIV-1 subtype O is significantly different in amino acid sequences from all other subtypes of HIV-1, there has been a need for developing a test for detecting antibodies in subtype O. For this purpose, the entire nucleotide sequence corresponding to the extracellular domain of the transmembrane glycoprotein of HIV-1 subtype O was synthesized with consideration of Escherichia coli cordon usage. Various regions of the extracellular domain were cloned into E. coli expression vectors and tested for levels of protein production. The nucleotide sequence, named ECTM, that can encode a 129 amino acid-long peptide, was found to be expressed at a high level in E. coli. The protein of approximately 17 kDa specifically reacted with sera from individuals infected with HIV-1 subtype O. The ECTM protein was purified to near homogeneity by the CM-T gel chromatography, using concentrated, denatured inclusion bodies. In Western blot analysis, the purified viral antigen reacted with sera from individuals infected with subtype O more efficiently than subtype B. The enzyme linked immunoabsorbent assay (ELISA) system was developed using the subtype O viral protein and compared with the commercially available kit lacking the antigens from subtype O. The ELISA kit containing the subtype O antigen ECTM alone efficiently reacted with sera from individuals infected with subtype O. The subtype O antigen-containing kit produced a positive absorbence even when sera were diluted 512-fold, suggesting a high sensitivity. The commercially available kit also reacted with subtype O sera, but produced a negative result at a dilution of 8-fold. Our results suggest that the currently available kit may not be able to efficiently detect subtype O sera and that the viral protein developed in this study may be added to the current system to maximize the detection of sera from individuals infected with subtype O.
Amino Acid Sequence ; Antibodies ; Base Sequence ; Blotting, Western ; Chromatography, Gel ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; Glycoproteins ; HIV* ; HIV-1* ; Humans* ; Inclusion Bodies ; Korea ; O Antigens

OBJECTIVES: To test the neurodevelopmental hypothesis of the schizophrenia, we compared MR brain scans of schizophrenic patients with headache patients. METHOD: We conducted 7mm-slice magnetic resonance imaging study to evaluate the prevalence of CSF in a sample of 28 headache patients and 23 schizophrenic patients. All subjects are right-handed person by Annett's questionaires. RESULTS: Any size CSF was fecund 13/23(56.5%)schizophrenics and 16/28(57.1%) of headache patients. But larger CSF was found 26.1% of schizophrenics and 10.7% of headache patients. No statistically significant difference in gender and clinical subtype. CONCLUSIONS: Higher incidence of CSF in schizophrenic patients supports the hypothesis that anomalous development of the brain is an important aspect of the schizophrenia.
Brain ; Headache ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Prevalence ; Schizophrenia*